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CRSwNP, another monoclonal antibody

Interleukins 4, 5 and 13 were shown to be important factors in type 2 inflammation, which characterises chronic rhinosinusitis with nasal polyposis (CRSwNP). In CRSwNP non-responders and those who recur short after-surgery monoclonal antibodies might be an answer. Examples include...

Upper airway endoscopy: achieving a balanced service whilst minimising the conflict of sustainability

Nasal endoscopes present a unique challenge in balancing sustainability and practicality. Both disposable and reusable scopes may have distinct roles in modern practice. Flexible endoscopy of the upper aerodigestive tract is an essential technique that facilitates detailed assessment of the...

Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis

Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...

Robotic surgery for squamous cell cancer: the new frontiers

Although the da Vinci platform was FDA approved for early-stage oropharyngeal cancers, the indications have expanded. In this article, John Hardman explains how surgeons, with greater understanding of the strengths and limitations of robotic surgery, have systematically set out to...

Compress to suppress the venous tinnitus

This interesting retrospective case series analyses the effectiveness of a modified surgical technique with retromastoid reconstruction of the sigmoid sinus by mechanical compression with Surgicel and bone wax packing under local anaesthesia for patients with venous pulsatile tinnitus related to...

Office-based otology procedures

This edition of the Otolaryngologic Clinics of North America covers office-based surgery in ENT. This article discusses procedures in otology that could be performed in the outpatient setting and covers innovations in office-based otologic procedures. The endoscope features prominently in...

‘Bare below the elbows’

So it has finally happened. I have reached that stage of reactionary bewilderment known as middle age. As well having my finger nowhere near the pulse of contemporary culture, I am finding the siren charms of BBC Radio 2 and...

“Close” surgical margin in oral tongue redefined, 2.2mm is as good as 5mm

Gold standard treatment of squamous cell carcinoma (SCC) of the oral tongue remains surgical resection of the primary tumour with negative margins. The primary goal is the complete excision of the tumour with no residual cancer cells left behind. A...

A novel way to reduce postoperative nausea and vomiting

This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with...

Are elective neck dissections needed during salvage laryngectomy?

There has recently been a move away from elective neck dissections in the setting of salvage laryngectomy. This has mainly resulted from an appreciation of the increase in morbidity, in particular pharyngocutaneous fistula formation, and an improvement in cross-sectional imaging...

Lymph node ratio is a significant predictor for loco-regional recurrence after neck dissection in patients with papillary thyroid cancer

Lymph node metastases are common in papillary thyroid cancer (PTC), yet the impact of nodal metastases on survival remains unclear. Lymph node density (LND) is the ratio between the number of positive lymph nodes excised and the total number of...

Leading and managing audiology service through a social enterprise model

As these things sometimes happen, our first conversations about Social Enterprise happened pretty much by chance and in our case were a by-product of discussions about a new department having outgrown the current one. The National Health Service (NHS) Audiology...